RT Journal A1 Baumgartner WA, Traill TA, Cameron DE, Fonger JD, Birenbaum IB, Reitz BA T1 UNique aspects of heart and lung transplantation exhibited in the 'domino-donor' operation JF JAMA JO JAMA YR 1989 FD June 2 VO 261 IS 21 SP 3121 OP 3125 DO 10.1001/jama.1989.03420210069018 UL http://dx.doi.org/10.1001/jama.1989.03420210069018 AB During the past 2 decades various refinements in heart and lung transplantation procedures have taken place. Improved preservation methods, new immunosuppressive medications, and advances in technical capabilities have allowed innovative procedures to be performed. In May 1987 the first "domino-donor" operation was performed in the United States. A 28-year-old man with cystic fibrosis and end-stage lung disease received the heart and lungs of an anonymous donor after he donated his heart to a 38-year-old man with end-stage ischemic cardiomyopathy. The technical and logistical aspects of this transplantation procedure are described herein. Other unusual features of this case that are discussed include heart-lung transplantation for a patient with cystic fibrosis, the use of cardiopulmonary bypass to allow lung procurement and transplantation across long distances, and the current role of heterotopic cardiac transplantation.(JAMA. 1989;261:3121-3125)